Outpatient

Age less than 2 months

Sepsis (e.g. toxic appearance, hypotension, poor capillary refill)

Immunocompromised patient

Vomiting or inability to tolerate oral medication

Lack of adequate outpatient follow-up (eg, no telephone, live far from hospital)

Failure to respond to outpatient therapy

Genitourinary abnormalities

Tablets not recommended in children less than 12 years old due to higher ratio of clavulanic acid to amoxicillin. Tablets are not equivalent to suspension.

Various formulations of suspension exist and are not all equivalent.

BID dosing is preferred for the 40 mg/mL suspension (Clavulin®-200)

To reduce gastrointestinal upset:

Administer with food

Limit clavulanic acid to approximately 10 mg/kg/day if possible

Use BID dosing schedule to reduce diarrhea

Avoid use in infants less than 2 months old unless other options are not available (do not use in infants less than 1 month old).

Sulfa antibiotics may displace bilirubin from protein binding sites, potentially leading to hyperbilirubinemia and kernicterus in neonates and young infants.